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The Urinary system and VAGINA, learn all about it. lol
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ASSESSING THE FEMALE GENITOURINARY SYSTEM
OutcomesIdentify pertinent genitourinary history questions.
Obtain a female genitourinary history.
Perform a female genitourinary physical assessment.
(Continued)
OutcomesDocument pertinent genitourinary assessment findings.
Identify actual/potential health problems stated as nursing diagnosis.
Differentiate between normal and abnormal findings.
Structures
Mons pubis Labia majora & minora
Clitoris Urinary meatus Perineum Bartholin’s glands Anus Cervix Uterus Fallopian tubes Ovaries Kidneys Urethra Bladder Vagina Skene’s gland
Anatomy and Physiology Review
FunctionsWhat are the functions of…
Mons pubis: Subcutaneous pad over symphysis pubis for protection
Labia majora/minora: Folds of adipose and connective tissue that protect and lubricate external genitalia
(Continued)
FunctionsWhat are the functions of…
Clitoris:Erectile tissue for sexual stimulation
Urinary meatus: Opening to urethra
Skene’s glands: Lubricate and protect
(Continued)
FunctionsWhat are the functions of…
Vaginal introitus: Opening of the vagina
Vagina: Muscular tube for copulation, birth canal, and menses
Bartholin’s glands: Secretes alkaline mucus that improves viability & motility of sperm
(Continued)
FunctionsWhat are the functions of…
Cervix: End of the uterus into vagina
Uterus: Hollow, muscular organ; site for fertilized egg implantation; protects fetus
(Continued)
FunctionsWhat are the functions of…
Tubes: Passage for ovum to uterus, site of fertilization
Ovaries: Produce ova, estrogen and progesterone
Kidneys: Filter and excrete wastes (Continued)
FunctionsWhat are the functions of…
Ureter: Connects kidneys to bladder
Bladder: Hollow muscular structure; holds urine
Urethra: Connects bladder to urinary meatus opening
Relationship to Other SystemsWhat is the
relationship of the female genitourinary system to other systems?
Integumentary Gastrointestinal
Lymphatic Musculoskeletal Cardiovascular Respiratory Endocrine Neurological
DevelopmentalVariations
Children—next quarter Pregnant clients—next quarter Older Women
Reproductive ability peaks in late 20’sEstrogen levels begin to decline, and between
46 & 55 menstrual periods become shorter, less frequent, & cease
Increased risk of infection (decreased vaginal secretions)
Cultural Variationspage 618
African Americans Asians Jews Native Americans Whites
Case Study Mrs. James, 29-year-
old, married, mother of 4-year-old daughter, housewife
C/O scant midcycle vaginal bleeding for past 2 months
Annual PAP test and gynecologic exam
SymptomsWhat symptoms would signal a problem with the female genitourinary system?
Vaginal discharge Lesions Vaginal bleeding, pain Amenorrhea Urinary symptoms
Pertinent History Findings Midcycle vaginal bleeding Taking BCP, occasional ASA + History of rheumatic fever Gravida 1/para 1; menarche 12; LMP 21
days ago, cycle every 21-23 days, menses 5 days, moderate-to-light flow.
Sexually active in monogamous, heterosexual relationship, satisfied with sexual performance
Physical AssessmentAnatomical landmarks: external--note
position of structures; internal--visualize underlying structures
Approach: inspection, palpation
Position: lithotomy
Tools: gloves, speculum, lubricant, light, slides and swabs for specimen collection
General survey and head-to-toe scan
InspectionExternal genitalia: color, hair
distribution, condition of skin, lesions, discharge, odor, pubic pediculosis, prolapse
Rectal area: condition of skin, lesions, discharge, bleeding, hemorrhoids, fissures
(Continued)
InspectionPelvic exam: color, lesions of vaginal
walls; color, lesions, discharge, position, size, shape, and patency of cervical os (obtain specimens)
Palpation Skene’s and Bartholin’s glands: masses,
swelling, discharge, tenderness Vaginal wall: texture, swelling, lesions,
tenderness Cervix: size, shape, consistency, position,
mobility, tenderness Uterus: size, shape, symmetry, position,
masses, tenderness
PalpationOvaries: size, shape, symmetry,
tendernessAnus and Rectum: sphincter tone,
tenderness, lesions, masses, hemorrhoids, polyps; test any stool for occult blood
Pertinent Physical Findings External genitalia pink, moist, intact; small
amount of white, ordorless discharge; no lesions
Vaginal walls and cervix pink, moist, intact; no lesions
Uterus anteverted, no masses, non-tender Ovaries and tubes non-palpable No rectal masses; hematest negative
Nursing Diagnosis
What actual or potential problems can you identify for Mrs.James?
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